Is Continued De-Incarceration Guaranteed?

jailAfter rising inexorably for more than three decades, the U.S. prison population has declined three years in a row. Few people see this as anything other than an extremely positive development. But will it last? Some prison policy watchers are more optimistic than others.

Mike Konczal is one of many smart people who has raised the worry that as The Great Recession disappears into the rear-view mirror, states will return to fiscal health and consequently lose interest in slashing prison budgets.

I don’t share Konczal’s anxiety, for two reasons. First, because the general pattern in U.S. history is for prison populations to grow rather than shrink during economic downturns, I am not convinced that The Great Recession was very important to the reversal of the 30+ year mass incarceration trend. Second, states like South Dakota whose public finances are already in rude health are nonetheless taking major steps to reduce incarceration.

A different case for pessimism, among some liberals at least, is that now that some prisons are privatized, the powerhouse lobbyists of that industry will prevent further de-incarceration. Some people on the political right are too reflexively fearful of government and too trusting of the private sector. Prison policy is a case where the opposite set of biases afflicts some analysts on the left. Over 90% of U.S. inmates are in public prisons. The political power of public sector unions on incarceration-related issues thus dwarfs that of the small private sector. If the private prison operators and public sector prison employees unions allied in the cause of preventing de-incarceration, it could be a significant political problem, but that’s not very likely because they hate each others’ guts.

Turning to the case for optimism, Charles Lane persuasively cites the impact of our still-falling crime rate:

Less crime leads to declining incarceration in two ways. First, and most obvious, there are fewer law-breakers to lock up. Second, safer streets reduce the public’s demand for tough “law and order” policies – like the stiff mandatory minimum sentences that helped drive the U.S. rate of incarceration up in the 80s and 90s.

Kevin Drum is even more upbeat based on his analysis of lead exposure research. He argues that the generation that grew up in the leaded gasoline era was uniquely violent. As they age out and are replaced by non-exposed generations, Kevin expects crime and incarceration rates to continue their fall.

You don’t have to accept the lead explanation to make an equally positive projection about the future. Prisoners tend to have long criminal histories that began when they were teenagers. As a result, the current size of the prison population reflects the crime rate of a decade or two ago better than it does that of the present moment. Ten years from now, the prison population will better reflect the low crime rate we have been enjoying in recent years, which translates into many fewer people serving hard time.

Hoffman and the Hype about “Killer Heroin”

Phillip-Seymour-HoffmanWithin hours of the death of Philip Seymour Hoffman, rumors spread that this magnificent actor had been taken from us by “killer heroin”. The threat of a batch of impurity-laced, unusually potent heroin is a staple of opioid overdose news coverage and popular debate. But it’s usually hype.

Hoffman’s tragic overdose was absolutely the norm: He died from a combination of drugs, not from impure or unusually strong heroin. The benzodiazepines may have been particularly lethal in that they, like alcohol, seem able to lower acute tolerance for opioids, thereby turning a user’s standard dose into an “overdose”.

Two people who will be totally unsurprised by Hoffman’s toxicological test results are addiction researchers Shane Darke and Michael Farrell:

If there’s one thing we can quite clearly say about heroin deaths, it’s that impurities are rarely, if ever, found or are relevant to the death. Those that are found are typically innocuous substances, such as sucrose.

Data on overdose deaths from legally-manufactured prescription opioids are the other reason to doubt the killer heroin hype that so regularly grips the media. Prescription painkllers are consistently pure and of knowable dose, yet they kill 5 times as many Americans a year as does heroin.

Sunday Afternoon Word Quiz: Fun with Spaghetti

Here’s a silly word game to help you while away your Sunday afternoon. Below are ten clues, each of which suggests a one word answer. To make the game easier, here is a hint: Every answer can be spelled using the letters in SPAGHETTI.

Put 5 minutes on the clock and see how well you can do. Answers and scoring after the jump.

1. “Crazy” card game
2. Meanness
3. Rose has the most
4. Consumes
5. Slang for being drunk
6. Lacunae
7. Kind of Infection
8. One is Black, one is Yellow, one is Red and one is White
9. Touts and servers love them
10. __________ cannot wither her, nor custom stale her infinite variety.

Continue Reading…

The Paradox of Acceptance and Psychological Change

Lindsay Holmes has penned a widely-circulated piece on what not to say to people with anxiety disorders. Many people respond to the chronically anxious with phrases like “Calm down”, “Why can’t you relax?” or “Just do it”. As she and I discussed, these well-intended responses often make people feel they have to fight to defend their anxiety to others, which makes their emotional state worse rather than better:

“Obviously if they could overcome this they would because it would be more pleasant,” Humphreys says. “No one chooses to have anxiety. Using [these phrases] makes them feel defensive and unsupported.”

In couple counselling sessions and in life more generally I have countless times listened to one person express a negative emotion and then another well-meaning person respond by tell them effectively that no, they don’t actually have (or should not have) the negative emotion they just revealed. I am sure I have done the same thing, and left suffering people feeling rejected as a result.

The humanistic psychologist Carl Rogers described a paradox of acceptance and psychological change that I often saw validated in my experience as mental health professional. Simply put, the moment people feel accepted in their misery is often the moment they begin to change. “Letting go” of anxiety, sadness, hurt, anger, grief and the like is not easy when someone tries to actively take it from us. Perverse as it sounds, we hang on to our dysphoria more rather than less when someone tries to argue us out of it. Yet when painful emotions are recognized and accepted, letting them go voluntarily suddenly seems possible.

If someone you love is suffering emotionally and you want it to stop, ordering them to change is likely only to generate mutual frustration. But being with them non-judgmentally in their suffering strangely enough can sometimes be the doorway to exiting it together.

Debating the Value of Blog Comment Sections

Austin Frakt of The Incidental Economist group blog recently discussed TIE’s decision to close off comments with Anna Maria Tremonti of CBC Radio One (full program here). One of the good points made in the discussion is that the costs and benefits of comment sections vary by blog. If you are running a big news website in the world’s most polite country and have staff hired to moderate your blog, even thousands of comments are manageable and valuable. In contrast, if you are operating an academically-oriented blog that has no paid staff like TIE, the comment section may feel like more work than its aggregate value justifies.

I miss reading the insightful commenters who used to be able to respond to my blog posts, but on balance am very happy with my decision to close off comments on most of my posts. The result has been that I have more time to engage on Twitter with knowledgeable people. I also have time to look at emailed comments from readers, and thus far at least have been able to respond to every one that was civil and substantive. Last but not least, I like knowing that in blogging I am no longer providing a platform for the subset of people who comment out of hatred, ignorance or intellectual dishonesty. That’s a lot of upside for one click on the WordPress template.

My suspicion is that in the long run, Twitter and whatever technologies succeeds it will supplant most blog comment sections as fora for interactions between bloggers and readers. In the meantime I can understand and respect why some bloggers choose to maintain them, and others do not: The variables in the cost-benefit analysis are qualitatively different from site to site and from person to person.

Why the Announcement of Edward Snowden’s Nobel Prize Nomination Increased My Admiration for my Fellow Professors

Two Norwegian politicians recently made news by issuing a press release announcing that they have nominated National Security Administration leaker Edward Snowden for a Nobel Peace Prize. Even though it violates the prize committee’s request to keep nominations private, similar press announcements are common each Nobel Peace Prize awards cycle (Literature nominations have also been disclosed over the years, though less frequently). The public announcement of Snowden’s nomination pleased some people and infuriated others. My main reaction was to feel increased respect for my professorial colleagues at Stanford and other schools of medicine.

Most people are unaware that many people are allowed to submit Nobel Prize nominations. For the Nobel Prize in Medicine or Physiology, full professors of medicine all over Scandanavia are always allowed to nominate, and this group is supplemented by academics of similar rank at a rotating list of other medical schools around the world. All full professors at Stanford Medical School and some other leading schools will therefore been asked at some point to serve as nominators.

To the press and the average person, being a “Nobel Prize nominee” is a magnificent, rare honor conveying credibility forever after. Any nominator who wants to boost someone’s profile can therefore do so by nominating them and then telling the press. As a result, the Nobel Prize nomination process is an opportunity both to celebrate achievement and to create mischief.

A nominator could nominate a completely deserving colleague at his/her medical school (which is ethical) and then inform their press office (which is not), thereby bringing some easy positive publicity to their university. A professor could also reveal to the press that s/he has nominated a powerful person in the hopes of currying favor (“I forgot that Francis Collins was the head of NIH when I nominated him for his extraordinary achievements, but yes, now that you mention it, I do have some grant proposals under review there…”).

More darkly, any professor of medicine who is a nominator could announce to the press that s/he has nominated Andrew Wakefield for a Nobel Prize in Medicine, thereby helping him to persuade more people to forgo vaccinating their children for mumps, measles and rubella. Likewise, a venal medical school professor could accept a financial inducement to announce the Nobel Prize nomination of someone hawking some ineffective food supplement or quack medical procedure.

Yet to my knowledge, no professor of medicine has ever done anything like this. Each year hundreds of them around the world submit their nominations and stay closemouthed about them. In an age of so much disclosure of virtually everything in the media and online, that speaks well of the standards of academic medicine and the character of the people in it.

I Wasn’t There, But Let Me Tell You Exactly What Happened

In response to my lament regarding how some people think watching movies makes them an expert in a public policy area, Kevin Drum points out a broader problem with how people judge what they do and don’t know:

Everyone with the manual dexterity to hoist a beer can regale you with confident answers to all the ills of society, while in the very next breath insisting that you don’t know what you’re talking about when it comes to subject X. That’s a lot more complicated than you think.

Subject X, of course, is something they happen to know a lot about, probably because they work in the field. But it doesn’t matter. The fact that they’ve learned to be cautious about the one field they know the most about doesn’t stop them from assuming that every other field is pretty simple and tractable.

It would be absurd to deny this sad phenomenon. Kevin is describing how possession of deep knowledge in some areas doesn’t generalize into an assumption that there is also relevant deep knowledge in areas in which we are not specialists. During some of the hottest cultural debates of recent years, I have been thinking about this same lack of generalization from the other direction: Why don’t we assume we are ignorant in unfamiliar areas when we have the experience of ignorance in familiar ones? I am thinking in particular of our quotidian experience of misunderstanding or misremembering our interactions with other people. Continue Reading…

Why I Do Not Warn Movie Viewers About Content That Could Be Upsetting

I take a break from film recommendations this week to address an ethical issue about film reviewing.

Beyond denoting some of my film recommendations as being for children (e.g., Treasure Island) and mentioning in other recommendations that a movie is definitely not for children (e.g., Layer Cake) I don’t provide any warning about content in movies that may be upsetting to viewers. I thought about this recently as I was writing a recommendation of a film about Southern white resistance to school integration (The Intruder, my recommendation of which will appear next month). I spent a few moments contemplating whether I should warn people that, for example, the film shows racist ugliness including violence and many people spouting the N word. I decided, keeping with my usual practice, not to do that. Here are my reasons for not including “viewer advisories” in my film recommendations, to which I welcome reactions and rebuttals.

1. Warnings about upsetting content can ruin a movie’s plot for viewers. I once saw the play – the title of which I will not share so that I don’t ruin it for you – which culminates in a murder after a long, tense build up. Unfortunately, everywhere in the theater and in the program were solemn warnings that there would be a gun shot during the play. I suppose that was intended to protect us in some way from emotional shock, but it’s true impact was to give away the ending of the play. 45 minutes before what was supposed to be the surprising conclusion, I was sitting there realizing “The gun shot hasn’t happened yet, so probably character A is going back to location B to confront character C whom we know carries a gun and then C will shoot and kill him”. That’s exactly what happened. The climactic confrontation scene itself had no tension for the audience from the moment the one character drew a gun. No one was wondering “Will he shoot him?”, rather we all knew he was going to shoot him because of the warnings plastered all over the theater.

Some magnificent movies could be ruined with viewer warnings. For example, if you’ve seen it, you will know that the impact of one terrific American film would be lessened if viewers were told up front: “This film includes a father’s impregnation of his own daughter, so don’t watch it if that is upsetting to you.” (I am not saying which film obviously, so that those who don’t know what movie I am referring to can still appreciate it).

2. It is impossible to know what is upsetting to everyone who might watch a movie I recommend. Depending on viewers’ personal histories and tastes, events in films can be traumatic to some people but not to others. The films I have recommended include some with frank portrayals of war, illness, death, divorce and poverty to name only a few of the things that some people might find traumatic. I don’t want anyone to be traumatized obviously, but I don’t see how I can guess for every or even most individuals what elements of a film might be bothersome.

3. Anyone who is upset by the content of movies does not need to watch movies. In the end adults are responsible for deciding whether they watch movies or not. If they do so, they are accepting the fact that sooner or later they will see something they find upsetting. Film reviewers don’t have the power to prevent that from happening, no matter how hard they might try to issue warnings about this or that. As for the artists themselves, I doubt filmmakers could succeed if they set the goal of creating movies that could not possibly upset anyone, anywhere. But I am sure that if they did try, it would be the death of cinematic art. If we have vibrant film industry, we will have films that are upsetting to at least some people. Anyone who can’t accept that should simply not watch movies.

Opioid Addiction is Everywhere

Many middle-class parents were appropriately rattled by Ben Cimons’ powerful account in Washington Post of being a “nice suburban kid” who became addicted to opiods and ultimately almost died of a heroin overdose. The desire of people from “good families” to believe that drug problems are confined to low-income urban communities is understandable, but also false — indeed perniciously so.

Ben and I, along with Wall Street Journal reporter Zusha Elinson and Stanford visiting fellow Markos Kounalakis were on Warren Olney’s To the Point radio program last week to discuss how heroin is making a comeback. Among the key themes of the discussion was that the origins of the recent rise of heroin can be traced directly to the recent and continuing extensive availability of prescription opioids.

p.s. I had a brain freeze when Warren asked me for the common trade names of hydrocodone-containing pain medications; I said Lortab but forgot to mention Vicodin.

The Challenge of Fictionalized Public Policy Areas

After a long and dispiriting day inspecting prisons, I reluctantly filled an obligation to attend a dinner party. After learning how I had spent my day, several of the guests went on at length about what prisons were like, who was in them, and what should be done about it. Almost everything the guests confidently asserted was factually wrong and dubiously sourced: I hadn’t heard so much discussion of Oz since that girl from Kansas and her dog went over the rainbow.

That’s the opening paragraph of my post at about widely-believed myths of American incarceration. It was stimulated by a recent conversation with a state’s attorney. Both of us had spent a significant amount of time visiting correctional facilities, poring over correctional data and talking to prisoners, wardens and guards. Yet both of us were used to people who had done none of these things giving us their “expert take” on what prisons are like, who is in them and what policies regarding prison should be adopted.

Nobody is informed about all areas of public policy. And most people don’t have trouble admitting that they don’t know anything about, say, the US-Brazil diplomatic relationship, Libor rate management, or sugar subsidies. But for a subset of public policy issues, a large number of completely ignorant people are dead sure they have all the facts (Granted, some arrogant people always feel this way, but put the ego-maniacs aside and look at the bulk of humanity). Prison is one of those areas, and I strongly suspect it is because there is so much fictionalization of it. If I were bored, I am sure I could easily list a hundred movies set in prisons. The Big House is also a common backdrop for TV shows, novels and comic books.

Given the human propensity to be moved more by vivid individual prototypes but insensitive to their representativeness or quantity, a really powerful movie about one fictional prisoner’s experience is probably going to shape public views of prison more than do the weighty Bureau of Justice Statistics tables that I ruin my eyes by reading. Likewise, all the powerful fictionalizations about family farm life, police investigative procedures and military combat probably also shape perceptions in agricultural, criminal justice and defense policy more than their truth-value would warrant.

It’s an impossible study to run, but it would be interesting to know if facts and genuine expertise have greater weight in public policy areas which don’t lend themselves well to fictionalization (e.g., waste water processing, telephonic regulation, pension management) because there aren’t as many people around saying “I know what to do because there was this awesome movie on TV last night…”